Individual
AMY L GRAY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LISW-S
Contact information
Practice address
1100 FAIRY FALLS DR STE 4, COSHOCTON, OH 43812-2803
(740) 722-9416
(740) 722-9418
Mailing address
69902 MOUNT HERMON RD, CAMBRIDGE, OH 43725-9464
(740) 705-1543
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
954452
OH
1041C0700X
Clinical Social Worker
I 0020357
OH
1041C0700X
Clinical Social Worker
Primary
I.0020357-SUPV
OH
Other
Enumeration date
12/19/2006
Last updated
05/13/2019
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